Your Next Job

Finding an ideal-for-you radiology job can be a daunting task. However, planning ahead can streamline the process.

Despite the changes that the radiology employment market has seen in the last decade, the prognosis is still good for new graduates, according to the 2013 ACR Commission on Human Resources Workforce Survey, released in October.

Hiring for the next few years is projected to be "relatively similar to what the hiring was like in 2012," says Edward I. Bluth, MD, FACR, chair emeritus of the Department of Radiology at Ochsner Medical Center in New Orleans and chair of the ACR Commission on Human Resources. Although the news that there are enough jobs to go around and that each of the approximately 1,200 residents who will complete training should be able to find a position is good news, there is one caveat according to the survey: It is not likely that everyone will be able to find a job in the subspecialty, geographic area, or type of practice that they desire.

Understand the State of the Field

According to Bluth, there are a number of reasons hiring remains flat. A big influence is that older radiologists are delaying retirement or, instead, are opting for reduced hours as a form of partial-retirement, until the economy fully recovers.

A second factor is uncertainty about how the Patient Protection and Affordable Care Act (PPACA) will impact practices and reimbursements in the future. Indeed, the CMS and insurance providers have already started cutting back on reimbursement levels, according to Bluth, which is limiting replacement hires for some practices.

Despite the replacement-hire cutbacks, there is a visible trend in groups growing in size, according to Bluth. "It's becoming commonplace to have 24-hour-coverage," he says. "Teleradiology started with the concept that there were companies that would be able to provide night-time service, but now many practices are internalizing that and hiring individuals directly to their practice, who are their own internal nighthawks."

That local groups are expanding night hours is a good sign, notes C. Matthew Hawkins, MD, a vascular interventional radiology fellow at the University of Washington/Seattle Children's Hospital and immediate past-chair of ACR's Resident and Fellow Section. "Because more and more departments and radiology groups across the country are trying to be in-house and have a human presence in their hospitals at night, I think it has helped the job market a little bit for younger people seeking jobs," he says.

Network, Network, Network

To secure the job that best fits their needs, Bluth recommends that residents begin networking early and that mid-career radiologists avoid neglecting their network, even after obtaining employment. "Since there is a paucity of jobs," he says, "word of mouth counts a great deal." Residents should attend local, state, and national radiology conferences, such as AMCLC and RSNA, "not just simply when looking for a job, but earlier, to get to know the individuals," Bluth says. In addition to residents, mid-career professionals should also attend conferences and expand their network. Through word-of-mouth, they can find out about positions that open up and also get recommendations for good people to hire.

Determining which subspecialties are needed in particular regions — information that can be gleaned through networking at local and state conferences — is also invaluable knowledge as residents plan their professional training and make decisions about where they would like to settle.

Do Your Research

Growing your network is only one of the first steps in landing a job. Residents also need to determine early on what type of practice they would like to work within and whether to be a generalist or specialist. "If you're going to an urban center where there are many radiologists and you want to join a large group, you need to be a specialist or subspecialist," says Bluth. "If you're going to a more remote area or a more rural area, then you probably want to be more of a general radiologist." Being a general radiologist is also important for nighthawk positions, he notes, whereas daytime work tends to be much more specialized.

"Personally, my belief is that if you are a subspecialist you will have greater security," Bluth says. "I believe that larger groups will be forming in the future and in order to be relevant in those groups, you will need special skills to distinguish yourself from everyone else."

But being able to offer more than subspecialty expertise is also important. "I think the next wave of residents is going to be seen as attractive to groups. Especially people who can figure out ways to generate alternative incomes for their groups," says Hawkins. "For example, groups may be interested in someone who can come in and take over all of the imaging protocols for their MRI machines or someone who is an expert in quality and safety."

Compare and Contrast

Once you have offers in hand, residents and mid-career professionals alike need to weigh those offers carefully. Bluth recommends talking to your network to make sure that you understand the reputation and culture of the group that you might be joining. For example, some groups only hire a portion of their radiologists on partner track, he says. Although that might not be a deal-breaker for some, it is important that candidates understand exactly what they are being offered.

Candidates also must make sure they understand the benefits package that is being offered, including health insurance, retirement plans, vacation, and disability policies, to name a few. "Each group has different policies; they're not necessarily uniform," Bluth says.

Maintain Your Skills

Doctors interested in moving practices mid-career, Bluth says, must maintain their skills. "Ensure that you're doing continuing education, that you're continuously updated, that you're relevant. You need to be able to bring value to a new group," Bluth says.

"The mid-career radiologist looking for a new job faces many challenges these days," says Charles William Bowkley III, MD, a diagnostic radiologist at Casper Medical Imaging in Casper, Wyoming, and chair of the ACR's Young and Early Career Physician Section. The economy and uncertainty about PPACA's effect on the field has made mid-career positions more difficult to find.

"There's no free lunch," Bowkley says. Doctors seeking to move practices need to convince a new practice that they will improve its overall appeal to both the community and local hospital systems. "You need to be willing to be available, whether or not you're the one on call. Building your business and building the trust of the referring community is no small feat," he says. "Once situated, you should volunteer for a position on a hospital committee. Building your practice means more than just being a good radiologist. Finally, you need to work hard. You don't want to be the part of the team that carries the lightest load, comes the latest in the morning, leaves the earliest in the evening, and leaves work for others."

Leave on Good Terms

Bluth recommends that mid-career radiologists consider letting their group know that they are interested in leaving so that the group can run a concurrent replacement search. "But first of all, you have to be certain that the grass is greener," Bluth warns. "In today's job market, I'd be very careful."

By letting your group know about your search plans, says Bluth, "people will be happy, and maybe they can try and convince you to stay, but at least there are no hard feelings." Leaving a group in the lurch without adequate time to find a replacement, however, can create a sense of bitterness that will affect your ability to get recommendations in the future. Whether or not you inform your group of your plans, it is vital to do all you can to ease the transition.

Look to the Future

Although the next few years look to remain static in terms of job opportunities, Bluth sees the potential for rapid change once the PPACA is implemented: "If there is truly a significant increase in access for uninsured people — and therefore a significant increase in volume — then I believe certainly that the job market will significantly and very rapidly change and there will be many job opportunities," he says. "And I predict that will occur. It's just a matter of when."